CMS Formulary

Displaying 126951-126960 of 1611142 results.
ID: 126951
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 1487528
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 126952
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 1720606
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 3
Qty Limit Days: 28
ID: 126953
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 1648789
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 126954
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 2170993
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 3
Qty Limit Days: 28
ID: 126955
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 2173822
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 3
Qty Limit Days: 28
ID: 126956
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 249066
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 126957
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 311671
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 126958
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 898367
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 126959
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 898378
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 126960
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 898372
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30